List Archives

Tue Aug 22 13:24:37 BST 2006

Connie,
While you are right in stating that the denial ability has had a
chilling effect on testing/screening, there is no excuse for NOT working
at a state and national level on this, for we must remember that, "In
2001 the NAIC (National Association of Insurance Commissioners)
unanimously voted to reverse its position and oppose its former policy
of denying payment to trauma centers for services provided to
intoxicated trauma victims, and now supports repeal of this law by state
legislatures."  
All this will take is a concerted effort by all of us, and our
representatives in our State legislatures and in the Congress.  
What is the hold up?
Ron
>>> "Connie Potter" <Connie at traumafoundation.org> 8/21/2006 1:08 PM
>>>
Re:  Law being repealed in last session in CT, this is not the case
except in 14 states.  Each state has its own statutes as to whether a
payor can deny payment to physicians and hospitals based on the
patient's toxicology or evidence that they are under the influence of
a
substance.  This has had a chilling effect on the willingness to
screen
for ETOH, etc. The national association that determines the UPPL's
(read
Larry Gentelillo, MD, FACS excellent article in the JOT re this issue)
has written a template for states to follow but this is not uniformly
followed.  What was once a "Bible Belt" type of issue has become
increasingly common means for payors to escape their obligations and
pass the bill on to other's insured and the taxpayers.  We support an
organized approach to making this type of denial illegal and will be
working to make that happen.  

Connie Potter, Executive Director
National Foundation for Trauma Care
(505) 525-9511

-----Original Message-----
From: Ronald Gross [mailto:Rgross at harthosp.org] 
Sent: Wednesday, August 16, 2006 9:20 AM
To: trauma-list at trauma.org 
Subject: Re: Alcohol Screening

I am happy to say that, at least in CT, that law was indeed repealed
in
the last legislative session!

>>> "William Bromberg" <brombwi1 at memorialhealth.com> 8/16/2006 9:54 AM
>>>
What are we to do with the insurance policies that deny payment for
alcohol-related MVCs? These laws need to changed.

Bill B

William J. Bromberg
Savannah Surgical Group
912 350-7412

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